The persistence of allergen exposure favours the decline in pulmonary function in allergic asthmatic workers.

The decline in pulmonary function is a normal feature of aging, but in asthmatics a more rapid progression is observed. This report aims at evaluating the influence of therapeutic intervention and allergen exposure avoidance in the decline of pulmonary function in allergic asthmatic workers. To this purpose 53 patients were recruited and their pulmonary function was monitored along 12±6 years: 25 (group A) changed their work after the diagnosis of asthma. 28 (group B) continued with their occupation. All were pharmacologically treated. A significant greater reduction of FEV1 and FVC respect to the predicted values (p <0.05 and <0.0001 respectively) were observed in all subjects, with a significant greater reduction of FVC (p<0.05) and FEV1 (p<0.01) in Group B respect to Group A. FEV1 decay was significantly greater among asthmatics with baseline FEV1 < 80% predicted (ANOVA, p < 0.03) and the FEV1 decay slopes were significantly steeper in the subgroup with a disease duration > 10 years and with a FEV1 variability >15% (ANOVA, p < 0.0001). Group A experienced a great loss of FEV1 during the first 3 years and then their FEV1 decay slopes declined with a similar trend of healthy subjects, on the contrary exposed asthmatics showed a slope characterized by a great variability with a steeper decrease of values. The study shows the allergen exposure is a determinant factor favoring the decline in pulmonary function in asthmatics so underlining the importance of allergic risk assessment and control in the treatment of asthmatic workers.